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Rationale- Anemia among pregnant women is a serious global health concern. According to WHO about 591,000 perinatal deaths and 115,000 maternal deaths globally are because of iron deficiency anemia directly or indirectly (1). Iron deficiency and its consequences continue to be prevalent in epidemic proportions despite major health reforms over past century. Although the adverse consequences on maternal and child health are well known and many government programs are running for the same for long time. Despite that it continues to be sub-optimally managed. Novelty- This study may be helpful for future planning strategies regarding anemia correction among mother and children in the countries with low resource settings like policy makers can think of two dose of Injectable iron as routine prophylaxis against anemia like tetanus toxoid (TT) in pregnancy. Aim-The aim of the study is to access burden of anaemia during pregnancy, its management with i/v iron and impact on maternal and perinatal outcome. Objectives- 1. To estimate burden of severe anaemia (Hb <7mg/dl) among pregnant women attending tertiary health centres. 2. To evaluate the effect of injection ferric carboxy maltose (single loading dose) and its comparison with iron sucrose (multiple doses) on haemoglobin level (gm/dl). 3. To determine association of antenatal haemoglobin with maternal, foetal and new born outcome. Subject & methods- All pregnant women beyond 16 weeks to 34 weeks attending antenatal OPD and labour room facility at the S. N. Medical college, District Women Hospital and MRHRU at community health centre Kheragarh, Agra, with haemoglobin less then 7gm/dl were enroled after taking proper consent during study period of 12 months. Along with routine investigations including complete blood count, liver function test, renal function test, peripheral blood picture, iron profile study (serum ferritin and total iron binding capacity), high-performance liquid chromatography and ultrasonography were performed. Dose of iron injection will be calculated Ganzoni formula iron requirement= 2.4 * weight (kg)*( target Hb-actul Hb) plus 500mg (storage) Single Injection of iron ferric carboximaltose (500mg to 1000mg i/v) in one group (350) and multiple doses of inj iron sucrose in other group of 350 pregnant women with iron deficiency anaemia (Hb >7gm/dl) were given. Complete blood count and iron study will be repeated after 3 and 6 weeks after i/v iron, and finally after delivery on mother as well as on newborn along with other required tests. Along with blood parameters we had also observe pregnancy related illnesses (pregnancy induced hypertension, gestational diabetes), mode of delivery, post-delivery complications, foetal growth restrictions, APGAR Score, NICU admission and mortality to access maternal and perinatal outcome. Primary outcome: Rise in hemoglobin in gm/dl Secondary outcome :serum ferritin, maternal wellbeing, delivery related complications and newborn wellbeing. The study showed that IV iron sucrose ferric carboxymaltose leads to faster and more sustained improvement in hemoglobin levels compared to IV iron sucrose. This also result in reduced maternal complications, better newborn outcomes (higher birth weights, lower preterm birth rates), and improved safety and compliance due to fewer doses. The findings contributed to optimizing anemia management during pregnancy, aligning with the goals of the *Anaemia Mukt Bharat (AMB)* initiative for reducing anemia in India.